Referral Coordinator

Reports to the Director or Practice Manager of the respective sites within BMG. Triage incoming referrals to schedule patients with the most appropriate provider, assists in coordinating health care services as necessary. Obtains and tracks referral data creating statistical reports and records including wait times, phone volume and referral tracking. Responsible for daily oversight of Referral Call Center and communicating operational issues to the director and/or practice manager.

MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Assists in the overall operational function of the assigned facility by:

• Working with administrative staff to develop and implement guidelines for prioritizing appointment types (acute vs non-acute) and scheduling with the most appropriate provider
• Reviewing technical statistical data for reports and records including wait times, phone call volumes, and referral tracking.
• Identifying, analyzing and resolving day to day issues with staff and patients.
• Ensures that patients are treat courteously by staff, maintain confidentiality.
• Acts as liaison between provider offices, physicians, health plans and other departments to ensure high quality customer service is being delivered.
• Maintains a good rapport and cooperative working relationships with all medical offices, hospital services, and community agencies.
• Possess an ability to deal effectively with high stress situations to evaluate current processes for enhancement and make necessary recommendations.

Performs routine clerical duties in accordance with established policies and procedures by:

• Receiving telephone calls, taking and relaying messages accurately and routing calls to appropriate office.
• Obtaining accurate information from referring office and/or patient.
• Interpreting the managed care report using knowledge of ICD 10, CPT and online insurance eligibility.

Assists with maintaining an efficient referral center by:

• Responding immediately to patient concerns with timely resolution follow up.
• Triaging incoming referrals and schedule patients with the most appropriate provider.
• Ensuring that patient data is accurately captured including insurance and other billing information.
• Accepts assignments of additional duties when indicated to maintain departments' operations.
• Assisting in monitoring the telephone system, patient call reports/statistics, and the answering service.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience

• The knowledge, skills and abilities as indicated are normally acquired through the successful completion of a high school diploma or equivalent; successful completion of an approved Medical Assistant Program or equivalent work experience of at least 3 years. Previous medical office experience, ICD 10, CPT, online insurance eligibility and specialty referral experience needed. Supervisory and/ or experience in both Sports Medicine and Orthopedic Trauma Surgery preferred.

Knowledge & Skills

• Demonstrates well developed communication skills to communicate effectively and clearly to a variety of internal and external contacts to maintain positive working relationships.
• Demonstrates analytical skills necessary to solve patient problems and interpret data.
• Requires a working knowledge of clinical and front office job duties.
• Demonstrate proficiency in computer skills (ie data entry, word processing, and spreadsheets). A basic understanding of database applications is desired.
• Requires solid office/secretarial skills, including the ability to operate standard office equipment as required by the needs of the office.
• Knowledge of insurance payers and verification of eligibility.
• Demonstrates leadership skills necessary to gain the cooperation and support from the staff.
• Requires the organization and analytical skills necessary to analyze situations/problems and provide timely resolution and work effectively with day to day problems.
• Knowledgeable in Allscripts, Cerner, referral database, excel, word, and outlook.

Working Conditions

• Work is performed in a medical office setting.
• May require local travel to different site office locations.

Physical Demands

• Requires the physical ability and stamina to perform the essential duties of the position.